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Review
. 2023 Jul 12;12(7):993.
doi: 10.3390/biology12070993.

The Role of Sex Differences in Bone Health and Healing

Elena Ortona  1 , Maria Teresa Pagano  1 , Lavinia Capossela  2 , Walter Malorni  3
Affiliations
Review

The Role of Sex Differences in Bone Health and Healing

Elena Ortona et al. Biology (Basel). .

Abstract

Fracture healing is a long-term and complex process influenced by a huge variety of factors. Among these, there is a sex/gender disparity. Based on significant differences observed in the outcome of bone healing in males and females, in the present review, we report the main findings, hypotheses and pitfalls that could lead to these differences. In particular, the role of sex hormones and inflammation has been reported to have a role in the observed less efficient bone healing in females in comparison with that observed in males. In addition, estrogen-induced cellular processes such as autophagic cell cycle impairment and molecular signals suppressing cell cycle progression seem also to play a role in female fracture healing delay. In conclusion, it seems conceivable that a complex framework of events could contribute to the female bias in bone healing, and we suggest that a reappraisal of the compelling factors could contribute to the mitigation of sex/gender disparity and improve bone healing outcomes.

Keywords: bone health; fracture healing; gender differences; sex differences.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
A schema showing the effects of estrogen and testosterone on differentiation, activity and survival of osteoblasts and osteoclasts.
See this image and copyright information in PMC

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